Dimensions, parent company of Prince George's Hospital Center, filed a petition for judicial review April 11 in Prince George's County Circuit Court. BWMC filed a similar petition Thursday. Both are affiliates of the University of Maryland Medical Systems, and both want a judge to review the Maryland Health Care Commission decision in March.

"This decision was not taken lightly and is based on the process by which the approval was granted," a BWMC spokesman said in a statement emailed to Capital Gazette on Thursday. "Our objective in being a party to this appeal is to ensure that decisions made by the MHCC regarding where and how cardiac surgery care is delivered are reached within the parameters of state regulations."

The spokesman for the hospital in Glen Burnie added that the commission's decision was "inconsistent" with several standards in the state health plan, specifically the requirement to quantify the potential impact a new program could have on other regional hospitals that offer cardiac surgery.

BWMC and AAMC submitted applications for an open-heart surgery program more than two years ago. Dr. Craig Tanio, who served as the applications' reviewer, recommended in December that the Annapolis hospital receive the certificate and denied BWMC. Tanio wrote that AAMC "has the highest potential for establishment of a lower charge cardiac surgery program that will also be high performing."

Since Tanio made his initial recommendation in December, regional hospitals and local politicians have been outspoken about the certificate of need applications. Prince George's politicians, including Senate President Thomas V. Mike Miller Jr., believe that a cardiac surgery program in Anne Arundel could hurt the upcoming Prince George's Regional Medical Center.

In January, County Executive Steve Schuh asked BWMC to withdraw its challenge to the program at Anne Arundel Medical Center. In a letter to Karen Olscamp, CEO of Baltimore Washington Medical Center, Schuh warned that continued fighting "threatened to undermine Anne Arundel County's chances of establishing a much needed cardiac care program."

Owen McEvoy, a Schuh spokesman, wrote in an email that the county executive "continues to feel that any court action threatens our jurisdiction from receiving a desperately needed cardiac care program."

"Lawsuits over the expansion of health services do not serve the public good," McEvoy wrote. He added Schuh continues to support AAMC and hopes the court will "not prevent the county from having a cardiac care program."

A spokeswoman for AAMC CEO Victoria Bayless emailed a statement Thursday saying that the hospital is "confident in the unanimous decision made by the MHCC" to approve an open-heart surgery program. The hospital added that legal filings are not "an unusual or unexpected part of the CON process."

Officials at Dimensions and the MHCC could not be reached for comment.